Titanic Vintage Dance Weekend Registration April 13-15, 2012

This registration form may be used for up to two people. If there are additional members of your party, please fill out additional registration forms as needed. We can invoice you for multiple registrations with one bill.

Registrant Information:

First Name (Registrant #1) *

Last Name (Registrant #1) *

First Name (Registrant #2, if applicable)

Last Name (Registrant #2, if applicable)

Mailing Address *

City *

State/Province *

Zip/Postal code *

Country

Phone (day) *

Phone (evening)

Email *

Please indicate type and quantity of tickets desired from the list below. For complete descriptions of events and ticket types, see our website (www.vintagedancers.org).

	1st Class (all events, Friday-Sunday)- $195 each
	2nd Class- Friday events- $25 each
	2nd Class- Saturday events- $150 each
	2nd Class- Sunday events- $40 each
	3rd Class- Steerage Dance (Friday)- $25 each
	3rd Class- Formal Tea (Saturday)- $45 each
	3rd Class- Dinner and Grand Ball (Saturday)- $110 each
	3rd Class- Museum Stroll (Sunday)- $15 each
	3rd Class- Concert (Sunday)- $30 each

Total Due *

Payment

Payment is required at the time of registration and may be paid by check or credit card. (If paying by credit card, it may take a day or two to receive your invoice to make payment, so don't be concerned).

Please be sure that you have provided an email address that you check regularly, as we will send you an invoice within a few days of receiving your registration. Invoices will be sent via PayPal, but please note that you do not need to have a PayPal account in order to pay by credit card, and you may also opt to print your invoice and mail payment by check.

I will pay by check

I will pay by credit card

Checks may be sent to:

Titanic Vintage Dance Weekend
c/o Katy Bishop, Registrar
P. O. Box 9
Nahant, MA 01908

Please make checks payable to "CVD."

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